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Velopharyngeal Competence in Children With Cleft Palate: Related Factors and Longitudinal Development

Schaar Johansson, Malin LU orcid ; Becker, Magnus LU orcid ; Stiernman, Mia LU and Klintö, Kristina LU orcid (2025) In Cleft Palate Craniofacial Journal p.1-11
Abstract
Objective
To identify factors associated with velopharyngeal competence at 10 years of age in children with cleft palate, and examine the longitudinal development of velopharyngeal competence.
Design
Registry-based cohort study.
Setting
Regional public care university hospitals in Sweden.
Participants
A total of 507 children born with a cleft palate with or without cleft lip/alveolus.
Main Outcome Measures
Velopharyngeal competence according to speech language pathologists’ ratings corresponding to the VPC-Rate with and without consideration of intervening secondary speech-improving surgery.
Results
Children with additional conditions had significantly lower odds of velopharyngeal competence with... (More)
Objective
To identify factors associated with velopharyngeal competence at 10 years of age in children with cleft palate, and examine the longitudinal development of velopharyngeal competence.
Design
Registry-based cohort study.
Setting
Regional public care university hospitals in Sweden.
Participants
A total of 507 children born with a cleft palate with or without cleft lip/alveolus.
Main Outcome Measures
Velopharyngeal competence according to speech language pathologists’ ratings corresponding to the VPC-Rate with and without consideration of intervening secondary speech-improving surgery.
Results
Children with additional conditions had significantly lower odds of velopharyngeal competence with no intervening speech-improving surgery than those without (OR 0.60, 95% CI 0.37-0.99). Children who had primary palatal surgery after 25 months of age (OR 0.23, 95% CI 0.11-0.49) or in more than 1 stage (OR 0.49, 95% CI 0.31-0.78), also had lower odds of a positive outcome, but these results may have been impacted by differences in cleft subtypes. Prevalence of velopharyngeal competence regardless of intervening surgery was 85% at age 5 years and 93% at age 10 years. For 17 children, velopharyngeal dysfunction emerged after 5 years of age.
Conclusions
Additional conditions were associated with decreased odds of velopharyngeal competence with no intervening surgery at 10 years of age. Whether primary palatal surgery performed late and in multiple stages also decreases odds of velopharyngeal competence should be investigated further. Prevalence of velopharyngeal competence increased from 5 to 10 years of age. Speech follow-up in children with cleft palate should continue until at least 10 years of age. (Less)
Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Cleft Palate Craniofacial Journal
pages
1 - 11
publisher
SAGE Publications
external identifiers
  • scopus:105005214270
  • pmid:40356551
ISSN
1545-1569
DOI
10.1177/10556656251339880
language
English
LU publication?
yes
id
6d97f1fd-5a07-45c2-b388-13f4d25c05cb
date added to LUP
2025-06-10 14:30:07
date last changed
2025-06-12 03:34:03
@article{6d97f1fd-5a07-45c2-b388-13f4d25c05cb,
  abstract     = {{Objective<br/>To identify factors associated with velopharyngeal competence at 10 years of age in children with cleft palate, and examine the longitudinal development of velopharyngeal competence.<br/>Design<br/>Registry-based cohort study.<br/>Setting<br/>Regional public care university hospitals in Sweden.<br/>Participants<br/>A total of 507 children born with a cleft palate with or without cleft lip/alveolus.<br/>Main Outcome Measures<br/>Velopharyngeal competence according to speech language pathologists’ ratings corresponding to the VPC-Rate with and without consideration of intervening secondary speech-improving surgery.<br/>Results<br/>Children with additional conditions had significantly lower odds of velopharyngeal competence with no intervening speech-improving surgery than those without (OR 0.60, 95% CI 0.37-0.99). Children who had primary palatal surgery after 25 months of age (OR 0.23, 95% CI 0.11-0.49) or in more than 1 stage (OR 0.49, 95% CI 0.31-0.78), also had lower odds of a positive outcome, but these results may have been impacted by differences in cleft subtypes. Prevalence of velopharyngeal competence regardless of intervening surgery was 85% at age 5 years and 93% at age 10 years. For 17 children, velopharyngeal dysfunction emerged after 5 years of age.<br/>Conclusions<br/>Additional conditions were associated with decreased odds of velopharyngeal competence with no intervening surgery at 10 years of age. Whether primary palatal surgery performed late and in multiple stages also decreases odds of velopharyngeal competence should be investigated further. Prevalence of velopharyngeal competence increased from 5 to 10 years of age. Speech follow-up in children with cleft palate should continue until at least 10 years of age.}},
  author       = {{Schaar Johansson, Malin and Becker, Magnus and Stiernman, Mia and Klintö, Kristina}},
  issn         = {{1545-1569}},
  language     = {{eng}},
  month        = {{05}},
  pages        = {{1--11}},
  publisher    = {{SAGE Publications}},
  series       = {{Cleft Palate Craniofacial Journal}},
  title        = {{Velopharyngeal Competence in Children With Cleft Palate: Related Factors and Longitudinal Development}},
  url          = {{http://dx.doi.org/10.1177/10556656251339880}},
  doi          = {{10.1177/10556656251339880}},
  year         = {{2025}},
}